Hand care in the workplace implicates both work related activities and worker health. Hand hygiene is essential for certain activities and services including particularly healthcare, food preparation and food service. Hand hygiene is important for virtually all workplaces to maintain a healthy environment and to limit spread of bacteria, viruses and other disease causing micro-organisms. Hand hygiene can be accomplished by washing with soap and water and by using liquids such as a sanitizing product which does not require water or rinsing of the product. Hygiene products that are used for hand hygiene are commonly dispensed by dispensers that are located where hand hygiene is desired. Hand skin care products can promote worker health in avoiding and treating hand skin conditions that can reduce worker performance and productivity. The invention concerns reporting use of hand care product dispensers for both hand hygiene and hand skin care.
The spread of healthcare acquired infections also known as HAI's has been an ever increasing challenge in healthcare facilities. HAIs can result from transmission of bacteria, viruses and other disease causing micro-organisms from various sources such as a patient or environmental surfaces to another patient or surface via the hands of healthcare workers. A consequence of such transmission can be infection of a patient who was previously not infected. Health care facilities have battled MRSA (methicillin-resistant staphylococcus aureus) and VRSA (vancomycin-resistant staphylococcus aureus) and other drug resistant micro-organisms for many years. These problems have been more apparent in recent years. It is estimated that approximately 2,000,000 such HAIs occur annually in the U.S. alone resulting in about 100,000 deaths. The extra costs associated with these infections are estimated in the billions of dollars.
Healthcare institutions seek to prevent and control the spread of HAIs. One important aspect of such efforts is seeking to ensure that health care professionals comply with hand hygiene best practices. One way to monitor compliance with hand hygiene best practices is to monitor use of hand hygiene product dispensers. Use of such dispensers indicates that hand hygiene has occurred. Dispensers have been adapted to report use such as dispensers disclosed by U.S. patent application Ser. Nos. 12/823,475 and 13/427,467 which are assigned to the applicant of this application and are incorporated herein by reference.
The World Health Organization has identified five moments of hand hygiene in a healthcare setting. Those five moments for hand hygiene actions are shown generally by FIG. 1 at 10. Specifically, the five moments for hand hygiene actions are 1: before patient contact; 2: before performing an aseptic task; 3: after body fluid exposure risk; 4: after patient contact and 5: after contact with patient surroundings. These five moments provide guidelines for hand hygiene within a healthcare setting. Compliance with such guidelines may be evaluated based on monitoring the number of hand hygiene events at locations within a healthcare institution.
Hand hygiene is also recognized as essential in the food industry to prevent the spread of foodborne bacteria and/or viruses including Norovirus, the Hepatitis A virus, Salmonella Typhi, Shigella spp., and Escherichia coli (E. coli) O157:H7 or other Enterohemorrhagic or Shiga toxin-producing E. coli, Staphylococcus aureus, Salmonella spp. and Streptococcus pyogenes. Hand washing by food employees is essential after activities that contaminate hands and before activities during which pathogens may be spread to food.
The Food and Drug Administration (FDA) recommends that food workers should wash hands when entering a food preparation area; before putting on gloves, including between glove changes; before engaging in food preparation; before handing clean equipment and serving utensils; when changing tasks and switching between handling raw foods and working with ready to eat (RTE) foods; after handling soiled dishes, equipment, or utensils; after touching bare human body parts, for example parts other than clean hands and clean, exposed portions of arms; after using a toilet; after coughing sneezing, blowing his or her nose, using tobacco, eating, or drinking; and after caring for or handling services animals or aquatic animals such as molluscan shellfish or crustaceans in display tanks. Food workers should also wash their hands after any activity that contaminates their hands. These recommendations provide bases for guidelines for hand hygiene in food facilities in which these activities and circumstances occur. Other national food safety agencies similarly recommend good hand hygiene practices, including the Food Standards Agency of the United Kingdom, the European Commission, and Food Standards Australia and New Zealand.
Food safety agencies, including the FDA have developed recommendations for managing facilities based on Hazard Analysis and Critical Control Point (HACCP) systems. Hand hygiene guidelines have been included in systems that are based on HACCP analysis. HACCP is based on seven principles, the fourth of which is monitoring critical control points. Where hand hygiene is essential, HACCP principles call for monitoring of hand hygiene. As for healthcare hand hygiene guidelines, food related hand hygiene guidelines may be evaluated based on monitoring the number of hand hygiene events at a location within a food facility.
Compliance with guidelines or recommended practices for hand care is monitored typically using one of a number of approaches including direct observation, tracking product consumption and more recently electronic monitoring systems have been applied to hand hygiene. Measuring compliance requires knowledge of both the number of hand hygiene events that have occurred (the numerator) and the number of recommended hand hygiene opportunities at which a guideline or recommended practice indicate that hand hygiene should have occurred (the denominator). Direct observation permits both the numerator and denominator to be counted not only at the overall level but also in detail by understanding which recommended hand hygiene opportunities have occurred. Unfortunately direct observation has a number of key deficiencies and problems, notably that it is very expensive to operate, results in only a very small percentage of the total number of hand hygiene opportunities being observed, and carries a well understood risk of over-statement of compliance due to the impact on behavior of being observed (the Hawthorn effect).
Other means of measuring compliance (product consumption, electronic monitoring), typically create a denominator in one of two ways; either the denominator is “measured” based on knowledge of worker location, or the denominator is calculated using statistically validated a-priori observations of hand hygiene opportunities. Examples of these approaches are discussed by U.S. patent application Ser. No. 13/669,988 which is owned by the applicant of this application and is incorporated herein by reference. Location based means of calculating the denominator are difficult and unreliable to align with guidelines such as the WHO 5 moments as the moments do not correlate well with measurable healthcare worker movement patterns, hence statistical based calculations for the denominator are preferred and enable precise calculation not only of the overall number of opportunities but also of the number of opportunities for each of the 5 moments within a statistically valid sample.
In either case however it is currently not possible to align the numerator (the actual number of hand hygiene events that occur) with specific guidelines or recommended practices. Rather the numerator is valid only at the overall level.